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Understanding Patients' Sexual Problems - A Reference Handbook for Healthcare Professionals
of: Grace Blodgett
BookBaby, 2015
ISBN: 9781483557885 , 492 Pages
Format: ePUB
Copy protection: DRM
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Understanding Patients' Sexual Problems - A Reference Handbook for Healthcare Professionals
CHAPTER ONE
MISCONCEPTIONS AND MISPERCEPTIONS THAT OFTEN RESULT IN MISCOMMUNICATION
“Sex lies at the root of life, and we can never reverence life until we know how to understand sex.”
— Havelock Ellis
The healthcare environment that exists in America today is such that honest, direct, and healthy discussions between healthcare professionals and patients about patient sexuality issues are extremely difficult at best. This difficulty is the result of social beliefs that a person’s sexuality is a private issue as well as the lack of education among healthcare professionals about sexuality and how to discuss it with patients. These difficulties also persist as the result of hundreds of years of history, culture, religion, and even turmoil that continue to influence all aspects of healthcare management and the practice of healthcare. A review of some of the conditions that lead to these differences are described below, according to the groups of people involved.
A. The sexualization of female nurses by themselves, patients, and the general public, and the perceptions held of them by patients and the general public
1. The sexualization of nurses from their perspective
• The majority of nurses are female (currently at approximately 90%), and the majority of research done on this topic has been performed on female nurses
• Just as there are different opinions within the general public about what is natural and healthy about sex, different opinions exist among nurses. Nurses are fraught with the same insecurities about their sexual behavior, and have similar issues with regards to their attitudes toward sexuality and sexual behaviors, as other members of the public
• The social mores, race, culture, place, politics, religion, etc. (social scripts) in which they were raised all influence nurses. In the area of sexuality, people are more influenced by those people with whom they had the greatest interaction as young children, specifically their parents (parental scripts) or other first caregivers and family
• If children only learn negative scripts, they become adults whose sexual education may be limited. If their education is based on sexual myths and full of negative stereotypes, it may hinder their perceptions of others and themselves; children who become nurses are no exception (see Appendix A)
• A commonly held belief is that only a heterosexual relationship within the bond of marriage is an acceptable and healthy sexual relationship. While another belief, at the other end of the spectrum, is that any sexual activity that is consensual and does not invade the rights of others is acceptable and healthy. Like many others, nurses are scattered along the spectrum in their sexual beliefs
• Nurses assume their own position on the gender continuum, and difficulties arise for them when they either align themselves with or act in conflict with others along that continuum
• Nurses also potentially carry their sexual concerns or issues with them, which can hinder their ability to discuss sexuality openly and warmly with others
• When nurses hear untrue opinions and unkind names and statements expressed against them by some members of the public, they begin to internalize them. Those statements may even become their actual beliefs about themselves
• Reynolds and Magnan 1 found that nurses believe it is their role to meet the sexual concerns of the patient; however, “discomfort, embarrassment, or strongly held attitudes about the nurses’ role in discussing sexuality with patients can act as barriers to these patient concerns.” They also found that “Time availability and confidence in one’s ability to address issues related to human sexuality present significant barriers to incorporating sexuality assessment and counseling into nursing practice”1
• Waterhouse2 found that nurses acknowledge it is their professional responsibility to address patients’ sexual issues, but they are not comfortable doing so
• Personal anecdotal comments received from nurses as to why they do not discuss sexuality with patients indicates the level of resistance that exists in the practice arena. Nurses claim they are too embarrassed, they were never taught how in nursing school, and such concerns are not a priority; they know hardly anything about the range of human sexuality themselves, let alone are able to teach others; they are too tongue-tied, and they don’t want to offend the patient. “I know I should, but I can’t, so I avoid it.”
• Numerous papers contain various reasons nurses have given as to why they do not include sexuality within their nursing practice3
2. The sexualization of nurses from the patients’ perspective
• Both participants in the patient-nurse relationship bring their own sexual experiences and beliefs to the situation, but nurses bring an additional burden with them that adversely influences their delivery of quality nursing care—that of being a sexual stereotype
• The images or stereotypes of nurses held by some members of the general public have changed frequently and dramatically, sometimes positively, sometimes negatively, from ancient times to the present. Nursing is perceived and portrayed as “being a metaphor for sex”3
• Much of the blame for these negative images has been assigned to the media; however, the past thirty years have demonstrated that this issue is more complicated than just media involvement and blame. These endless references to the sexuality of nurses damages their reputation, the value and worth of the work they perform, and discounts their preparatory and continuing preparation, their hard work, and the commitment it takes to become a professional nurse
• Some names and descriptions used by the public for nurses are related to the historical religious and military roles of nurses, as well as nursing initially being a calling for women. These names and descriptions include: angels in white, sweet, battleaxes, torturers, saintly domestics, bimbos, kind, drunken sots, witches in white, fannies, oversexed, handmaidens to physicians, unselfish and dedicated, Nurse Ratcheds, sexual playthings, and naughty night nurses
• Why these derogatory terms are applied to nurses and why the profession of nursing has been selected as a target out of the female professions that exist (librarians, physical therapists, teachers, occupational therapists, etc.) is unclear
• Kalisch and Kalisch4 examined the character depictions of 677 nurses and 466 doctors in films, television, and novels between 1920 and 1980. They found that there was a steady decline in the way nurses were depicted, while depictions of the doctors remained consistently positive or actually showed improvement. Female nurses were perceived as being “promiscuous playthings” for the physician and the patient, an “easy sexual harassment target; sexually provocative, and all-knowing about things sexual”
• Nurse researchers in England and Ireland recently viewed the ten most-watched videos within 300,900 YouTube hits that showed a negative or positive image of nursing.5 They examined them for language, actions, content, and intent, and the results classified nurses into three categories: knower/doer, sexual plaything, and witless incompetent
• Nurses are neither saints nor sinners; they have an important job to do and want to do it professionally and expertly without having inappropriate and denigrating names attached to them
• Nurses are encouraged to respond with thoughtful, proactive actions to stem this almost unending onslaught of offensive name calling. Accurate, honest, and responsible self-descriptions must be given by nurses of who they are and what they represent—intelligent, educated, skilled, knowledgeable professionals who fulfill one of society’s absolutely essential roles, that of caring for the sick
B. The perceptions of physicians’ sexuality, demeanor, and attitude, as seen by healthcare professionals, patients, and the general...
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